不同真空采血管对锌锂测定的影响

目的:评价不同真空采血管制备的血清对测量血锌锂结果的影响.方法:收集60例受检者的普通真空采血管、分离胶促凝真空管、肝素钠抗凝管以及分离胶促凝真空管制备血,其中30例从正在服用碳酸锂治疗的病人抽取,分析四种不同采血管处理的同一标本.结果:锌用4种采血管处理的结果差别无统计学意义,锂使用添加剂肝素钠和促凝剂处理的标本结果...     

普通真空采血管与促凝真空采血管不同时间检测电解质的应用对比

目的对比探讨普通真空采血管与促凝真空采血管不同时间检测电解质的应用效果。方法选取2012年1月至2016年6月在我院进行健康体检者120例,采集所有体检者早晨空腹肘静脉血4~6 mL,平分为2份,一份使用普通真空采血管(对照组),一份使用促凝真空采血管(观察组),采血后0.5 h、1.0 h与2.0 h进行电解质的检测,取平均值。结果采血后观察组的血清K~+、Na~+与Cl~-含量分别为(3.98±0.24)mmol/L、(142.50±2.10)mmol/L和(102.40±2.71)mmol/L,而对照组分别为(4.23±0.25)mmol/L、(142.04±2.50)mmol/L和(101.02±2.56)mmol/L,观察组检测血清K~+含量明显低于对照组(P<0.05)。结论相对于普通真空采血管,促凝真空采血管的应用能加快检测时间,能满足不同时间检测电解质的要求,值得推广应用。     

血液高效促凝剂的促凝效果及其对生化检验项目结果的影响研究

目的对血液高效促凝剂的促凝效果及其对生化检验项目结果的影响进行探究。方法以2017年1月来我院体检的健康人的血液标本为研究对象,利用真空采血管收集其中40位纳入对象的血标本,观察促凝效果;借助全自动生化分析仪检测另外30个样本的常用生化指标,分析比较未加入与加入血液高效促凝剂对检验结果的影响。结果 40支加入高效血液促凝剂的采血管在3～5 min均完成凝集,静置离心后血细胞与血清界限清楚、血清清澈、未出现挂壁现象,所得血清标本效果理想;加入与为加入血液高效促凝剂的常用生化检测项目的结果差异不大,无统计学意义(P>0.05)。结论血液高效促凝剂在增强促凝效果方面具有积极意义,能够获取理想血清标本,提高工作效率,同时促凝剂的加入对生化检验结果的影响不大,在临床具有较高的应用价值。     

促凝剂对临床电解质及肾功能检查结果的影响研究

目的 探讨促凝剂对临床电解质及肾功能检查结果的影响.方法 对38例患者血液标本进行电解质检查,将38例患者分别取4 ml血液放置于普通真空试管和含有促凝剂真空试管中,比较两组血液样本中K、Na、CI、Ca、Mg、Pi是否有差异.对同期86例患者进行肾功能检查,将血液标本分别放置于普通真空试管和含有促凝剂真空试管中,比较两组标本的总蛋白(TP)、白蛋白(ALB)、血尿素氮(BUN)、血肌酐(CfEA)、尿酸(UA)、二氧化碳(CO2)、半胱氨酸蛋白酶抑制剂c(CvsC)、微球蛋白(β2βG)是否有差异.结果 电解质检查组中,促凝剂使用组K、Na、CI、Ca、Mg、Pi与未使用促凝剂组无明显差异(P>0.05).肾功检查组中,促凝剂使用组I-P、ALB、BUN、CREA、UA、CO2、CvsC、β2MG与未使用促凝利组无明显差异(P>0.05).结论 对血液进行电解质和肾功能检查中使用促凝剂并不会对结果产生影响,临床应用价值较大.     

促凝剂使用对临床血脂检查的结果影响分析

目的探讨使用促凝剂对临床血脂检查的影响,以供临床参考。方法对东莞市大岭山医院2010年10月至2011年4月门诊34例健康体检人群作为本次试验研究对象,每位受试者同时分别取4mL血液标本于普通真空试管和含有促凝剂的真空试管中。观察两组血液的血脂检查结果的CHO、TG、ApoA、ApoB、HDL、LDL、GLU是否存在差异。结果使用促凝剂与未使用促凝剂的标本检查结果存在一定差异,二者检测结果相等者CHO2例、TG5例、ApoA14例、ApoB8例、HDL-C1例、LDL-C1例、GLU1例。但使用促凝剂与未使用促凝剂的标本,各检测结果平均值差异经统计学分析,P>0.05,无统计学意义。结论使用促凝剂会造成血脂血糖检查中出现差异,但对血脂检查结果影响不大,差异无意义,可在血液检查中应用。     

不同样品采集管对血液常规生化检测结果影响的探讨

目的:探讨不同样品采集管对血液常规生化检测结果的影响。方法:选择一次性塑料管、反复洗涤干燥后的玻璃管、普通肝素钠抗凝管和真空分离胶采血管,采集来院进行健康体检的200名体检者静脉血10ml均分4份装入,离心后按照操作技术规程上机检测16项常规生化项目。结果:一次性塑料管的K+略高而GLU、ALT、AST、ALP、LDH略低于普通肝素钠抗凝管和真空分离胶采血管;反复洗涤干燥后的玻璃管有K+、Ca2+、BUN明显高于普通肝素钠抗凝管和真空分离胶采血管,而GLU、ALT、AST、ALP、LDH明显低于普通肝素钠抗凝管和真空分离胶采血管;普通肝素钠抗凝管和真空分离胶采血管结果比较一致。结论:不同样品采集管对血液常规生化检测结果有一定影响,采集血液标本首选真空分离胶采血管为宜。     

浅析3种真空采血管对临床生化检测结果的影响

目的探析3种真空采血管对临床生化检测结果的影响。方法随机选取本院2014年12月至2015年12月收治的门诊受检者60例,清晨空腹采取一针静脉血,分为三管,分别置于普通真空采血管、分离胶促凝真空管、肝素盐抗凝采血管中各5 mL,对比其生化检验结果。结果 3种真空管仅在几项结果中有所差异,但差异并不具有统计学意义(P<0.05)。结论 3种真空管在临床检测上各具特性,若要确保检测结果不受影响,应依据其样本特点为其选择合适的真空采血管。     

国产与进口真空采血管检测血常规结果相关性分析

目的通过对国产与进口两种不同EDTA真空采血管进行比对分析,探讨国产与进口ED-TA真空采血管检测白细胞（WBC）、红细胞（RBC）、血红蛋白（HGB）、红细胞比积（HCT）、血小板（PLT）等主要血常规指标是否具有可比性。方法在门诊患者中随机选取20位患者,空腹12h抽取静脉血,分别置于国产、进口EDTA真空采血管,并立即检测WBC、RBC、HGB、HCT、PLT等指标。结果两种真空采血管所采集标本的WBC、RBC、HGB、HCT、PLT等的相关系数（r）分别是0.9984、0.9978、0.9982、0.9969、0.9976,无明显差异（P〉0.05）。结论用国产真空采血管代替进口真空采血管应用于血常规项目检测可以满足临床的需要。     

多发性骨髓瘤患者生化试验标本分离方法的探讨

目的 探讨多发性骨髓瘤（Multiple Myeloma,MM）患者生化免疫试验标本的分离方法.方法在样本前处理条件且离心转速与时间相同情况下,使用普通玻璃干管,分离胶管,肝素锂抗凝管分离MM患者血清（浆）并分别检测其常用生化指标,比较其结果有无显著性差异.结果 在样本前处理条件且离心转速与时间相同情况下,普通玻璃干管不能离心出足够生化检测的量的血清,使用分离胶试管,肝素锂抗凝试管则能分离出足够生化检测的量的标本.检测MM患者血清（浆）标本12项临床常用生化指标,部分结果间差异有显著性（P 〈 0.05）.结论 通过使用分离胶试管或肝素锂抗凝试管可以分离出多发性骨髓瘤（Multiple Myeloma,MM）患者足够临床生化、免疫实验用的血清（浆）标本.由分离胶试管离心产生的血清标本所做的12项临床常用生化检测结果较肝素锂抗凝试管离心产生的血浆标本偏差更小,结果更接近真实值,也更可靠.     

不同真采血管及放置时间血糖检测对GMD诊断的影响

比较3种不同真空采血管采集的血液样本放置不同时间血糖检测结果对妊娠期糖尿病（GDM）诊断的影响。分别使用灰色、红色和绿色真空采血管采集孕24～28周孕妇的空腹血各1管,将其在室温下（18～25 ℃） 放置5 h,每隔1 h使用己糖激酶法（HK法）进行血清（浆）葡萄糖含量测定,观察3种真空采血管葡萄糖检测结果随时间变化的情况及其对GDM诊断结果的影响。灰色、红色和绿色真空采血管各时段的血糖检测结果相互比较均具有显著性差异（P＜0.01）;使用灰色真空采血管采集的样本其葡萄糖检测结果受放置时间的影响最低,而红色和绿色管血糖检测结果随样本放置时间的增加而明显降低,且红色管下降速度最快。灰色管各时间段GDM的阳性诊断率最高,绿色管次之,红色管最低;使用灰色管采集的样本在3 h内检测的血糖结果对GDM诊断无影响（P＞0.05）;与各时段灰色管GDM诊断阳性率比较,使用红色管采集的样本均具有显著性差异（P＜0.01）,而使用绿色管采集的样本在1 h内无显著性差异（P＞0.05）。使用灰色真空采血管采集样本各时段的血糖检测结果和GDM阳性诊断率均高于红色和绿色真空采血管,并且最准确、最稳定,受样本放置时间的影响最低。     

Time-dependent absorption of therapeutic drugs by the gel of the Greiner Vacuette blood collection tube

Stability of therapeutic drugs in sera collected in Becton-Dickinson VACUTAINER serum separator SST tubes has been well studied. Recently, the Greiner Vacuette serum separator tube has become available for blood collection. However, stability of therapeutic drugs in sera when the specimen is collected in the Greiner tube has not been reported. The authors studied the stability of 15 commonly monitored drugs in sera when stored on the gel of the Greiner serum separator tubes. The drugs studied were amikacin, gentamycin, tobramycin, vancomycin, digoxin, quinidine, theophylline, carbamazepine, phenobarbital, phenytoin, valproic acid, tricyclic antidepressants, salicylate, acetaminophen, and ethanol. The authors compared the concentrations of drugs in sera stored in plain tubes (no gel) and in sera stored in the Greiner tubes containing serum separator gel. They observed a significant decline in the concentrations of tricyclic antidepressants when stored in the Greiner tubes. Interestingly, concentrations of amitriptyline declined more than its metabolite nortriptyline and concentration of imipramine also decreased more than its metabolite desipramine. The concentration of carbamazepine also decreased slightly over time when serum was stored in the Greiner tube. Although declines in carbamazepine concentrations on prolonged storage in the Greiner tubes were statistically significant, the decreases may not be clinically significant. The concentrations of the other drugs studied did not decline when stored in the Greiner tubes. The authors conclude that the Greiner brand tube is not suitable for blood collection for analysis of tricyclic antidepressants.     

Assessment of the Corvac blood collection tube for drug specimen processing

The Corvac integrated serum separator tube (TM Monoject Scientific) has been examined for use in processing specimens for drug analysis. This study was undertaken because the SST serum separator tube (Becton-Dickinson) was shown to cause decreases in drug levels of lidocaine, pentobarbital, and phenytoin, which were dependent upon blood volume and time of contact with the gel. Pools of donor blood were spiked with lidocaine or phenytoin and processed in Corvac tubes and red top tubes. Lidocaine levels were depressed by 5.2% when Corvac was used. Phenytoin levels were unchanged. The lidocaine depression was independent of blood volume, time of gel contact, or tube lot number. Paired patient specimens for quinidine, lidocaine, or theophylline analysis were obtained in Corvac and red top tubes. Lidocaine levels were depressed by 6.0% (p less than 0.01). Quinidine and theophylline levels were unchanged. All drug analyses were carried out using the Syva enzyme multiplied immunoassay technique. The Corvac tube has been shown to cause decreased levels of lidocaine but not of the other drugs tested. Corvac (silicone gel) results differ from SST (polyester gel) results because of the different construction of these tubes.     

Comparison of blood ethanol concentrations in samples simultaneously collected into expired and unexpired venipuncture tubes

Blood sample collection kits manufactured for the Minnesota Bureau of Criminal Apprehension contain venipuncture tubes with an expiration date that the tube manufacturer utilizes to ensure sufficient vacuum to fill the tubes. Legal challenges to blood ethanol analyses that involved the use of expired venipuncture tubes prompted a study comparing ethanol analysis results in expired venipuncture tubes (up to 74 months beyond the expiration date) and in unexpired venipuncture tubes. Blood samples were collected during controlled drinking sessions using 10-mL venipuncture tubes containing 100 mg of sodium fluoride and 20 mg of potassium oxalate and were analyzed by headspace gas chromatography. The data obtained indicate that the ethanol concentrations in the expired and unexpired venipuncture tubes were statistically identical.     

The stability of human blood lead in storage

Whole blood specimens from 12 occupationally exposed workers were stored for 10 weeks either in heparin or EDTA at 22 degrees, 4 degrees, and -20 degrees C for the study of the stability of lead in storage. The lead concentrations of these specimens ranged from 226 to 616 micrograms/L. Polypropylene and vacutainer tubes were used for storage. A Zeeman Graphite Furnace Atomic Absorption Spectrophotometer was used to determine the lead concentration. No loss of lead was found on the 12 specimens stored with heparin or EDTA at three different temperatures in all containers over the 10-week period. The variation of the lead concentration is comparable to the average precision of two quality control specimens, Tox-EL 1 and Tox-EL 2, of 7.4% and 6.1%. The use of the original vacutainer tubes with either heparin or EDTA and refrigerated temperature (4 degrees C) for the storage of human whole blood specimens for routine lead determination is recommended.     

Comparisons of 1,3-butanediol and glycerol on several behavioral measures

Summary Experiments employing rats as Ss were performed to determine the behavioral effects of a prototypic synthetic nutrient, 1,3-butanediol (BD), and to compare these effects with those of glycerol. The following results were obtained: a) When administered intragastrically to semi-deprived and non-deprived rats, moderate levels of both BD and glycerol depressed voluntary running activity more than did isocaloric and isovolumetric control substances. b) For both compounds this depression increased monotonically with increasing dose level, but the effects of BD became relatively more profound than those of glycerol as dose size increased. c) Both compounds monotonically depressed food intake as a function of dose level in tests conducted 3 hr after intubation. d) The depression of food intake also occurred in restrained Ss, thus was not simply an artifact of depressed activity. e) Increasing doses of BD monotonically depressed water intake for a 3-hr period following intubation, but Ss under BD could be induced to drink extensively by administering hypertonic salt solutions. f) Increasing glycerol loads had no effect on water intake when running was permitted but increased water intake when running was not permitted. g) At the highest dose level tested BD profoundly disrupted equilibrium, but glycerol had no effect. These findings suggest that BD may act as a CNS depressant or muscle relaxant but that glycerol most probably is neither.This research was conducted at the Pioneering Research Laboratory, United States Army Natick Laboratories, Natick, Massachusetts. The authors wish to thank William K. Calhoun of the Nutrition Division, Food Laboratories, United States Army Natick Laboratories, who provided research facilities and encouragement during the course of this research. Acknowledgment is also due to Miss Mary Bergeron who helped collect the data.     

Coagulant proteinase from Bothropscolombiensis venom

The venom of $\text{Bothrops}$$\text{colombiensis,}$ like other Crotalidae venoms, contains thrombin-like activity. We purified a mixture of isoenzymes by chromatography of the crude venom on DEAE-Sephacel where coagulant proteinases were separated from other proteolytic enzymes. By subsequent chromatography on Sephadex G-100 we obtained coagulant proteinase as a single band on acrylamide gel electrophoresis at pH 7.5 which showed 4 major protein bands when subjected to flat gel isoelectric focusing. This heterogeneity is presumably due to carbohydrates present in this glycoprotein. The native molecular weight of the coagulant proteinase was found to be over 90 000 by gel filtration. SDS electrophoresis showed, however, that the monomer molecular weight is around 67 000. The specific coagulant activity of the purified enzyme was increased 13 fold by purification and was 231 NIH units/mg. The optimal pH for coagulation of bovine fibrinogen was at pH 7.0. The enzyme shows maximal stability in the pH range 5–6 when incubated for 1 hr at 37 °C. The intraperitoneal LD₅₀ for white mice was 4.0 mg/kg. The enzyme is similar to other known coagulant proteinases from snake venoms and thus potentially useful as a therapeutic agent.     

Effect of blood sample tubes on amiodarone and desethylamiodarone concentrations

We have investigated the change in amiodarone and desethylamiodarone concentrations in blood sampled from three different Vacutainer tubes: (a) sodium heparin, (b) gel separator (SST), and (c) no additive (plain tube). Amiodarone and desethylamiodarone concentrations were determined by a reverse-phase high pressure liquid chromatography technique in samples from 12 subjects on chronic amiodarone therapy. Amiodarone concentrations were significantly lower in plasma compared with serum from either gel separator (11.5%, p = 0.05) or no additive (13.5%, p = 0.01) tubes. Desethylamiodarone concentrations were significantly lower in plasma compared with serum from gel separator tubes (8.5%, p = 0.04) and were slightly lower compared with no additive tubes (4.4%, p = 0.41). Serum amiodarone and desethylamiodarone concentrations from either no additive or gel separator tubes yielded similar results. We conclude that significant amiodarone and desethylamiodarone concentration differences occur between serum and plasma, and that no binding of amiodarone and desethylamiodarone to the separator gel occurs.     

贵州某三甲医院血培养分离病原菌分布及耐药性分析

目的分析贵州某三甲医院2020年1月至2020年12月血培养的病原菌分布特点和耐药性情况,为临床血流感染的诊断和治疗提供依据。方法血培养采用美国BD公司BACTEC FX全自动血培养仪,细菌鉴定和药敏试验使用美国贝克曼MicroScan WalkAway 96全自动细菌培养仪完成,采用WHONET5.6软件对结果进行统计分析。结果全年共收集21497例血培养,其中阳性标本共计1488例,阳性率为6.9%。分离病原菌共1046株,其中革兰阴性菌548株,占52.4%;革兰阳性球菌398株,占38.0%;革兰阳性杆菌3株,占0.3%;真菌97株,占9.3%。主要病原菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌,构成比分别为17.5%、12.1%、7.3%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌108株,检出率59.1%。碳青霉烯类耐药的大肠埃希菌(CR-ECO)2株,检出率为1.1%;碳青霉烯类耐药的肺炎克雷伯菌(CR-KPN)54株,检出率为42.5%;耐碳青霉烯类鲍曼不动杆菌(CR-AB)37株检出率为77.1%;耐甲氧西林金黄色葡萄球菌(MRSA)26株,检出率为34.2%,未发现利奈唑胺、万古霉素耐药的金黄色葡萄球菌。结论我院血培养分离菌以革兰阴性菌为主,多重耐药菌检出率较高,根据病原菌的药敏结果用药十分重要。